Development and validation of the Vietnamese primary care assessment tool.
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ABSTRACT:
SUBMITTER: Hoa NT
PROVIDER: S-EPMC5764365 | biostudies-other | 2018
REPOSITORIES: biostudies-other
Publications
Development and validation of the Vietnamese primary care assessment tool.
Hoa Nguyen Thi NT Tam Nguyen Minh NM Peersman Wim W Derese Anselme A Markuns Jeffrey F JF
PloS one 20180111 1
<h4>Objective</h4>To adapt the consumer version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity.<h4>Design</h4>A quantitative cross sectional study.<h4>Setting</h4>56 communes in 3 representative provinces of central Vietnam.<h4>Participants</h4>Total of 3289 people who used health care services at health facility at least once over the past two years.<h4>Results</h4>The Vietnamese adult expanded consumer version of the PCAT (VN PCAT-AE) ...[more]
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Project description:AimTo adapt the provider version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity.BackgroundThere is a growing need to measure and explore the impact of various characteristics of health care systems on the quality of primary care. It would provide the best evidence for policy makers if these evaluations come from both the demand and supply sides of the health care sector. Comparatively more researchers have studied primary care quality from the consumer perspective than from the provider's perspective. This study aims at the latter.MethodOur study translated and adapted the PCAT provider version (PCAT PE) into a Vietnamese version, after which a cross-sectional survey was conducted to examine the feasibility, internal consistency and validity of the Vietnamese PCAT provider version (VN PCAT PE). All general doctors working at 152 commune health centres in Thua Thien Hue province had been selected to participate in the survey.FindingsThe VN PCAT PE is an instrument for evaluation of primary care in Vietnam with 116 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. From the translation and cultural adaptation stage, two items were combined, two items were removed and one item was added. Six other items were excluded due to problems in item-total correlations. All items have a low non-response or 'don't know/don't remember' response rate, and there were no floor or ceiling effects. All scales had a Cronbach's alpha above 0.80, except for the Coordination scale, which still was above the minimum level of 0.70.ConclusionThe VN PCAT PE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the provider perspective.
| S-EPMC6609979 | biostudies-literature
Project description:BACKGROUND:Malawi does not have validated tools for assessing primary care performance from patients' experience. The aim of this study was to develop a Malawian version of Primary Care Assessment Tool (PCAT-Mw) and to evaluate its reliability and validity in the assessment of the core primary care dimensions from adult patients' perspective in Malawi. METHODS:A team of experts assessed the South African version of the primary care assessment tool (ZA-PCAT) for face and content validity. The adapted questionnaire underwent forward and backward translation and a pilot study. The tool was then used in an interviewer administered cross-sectional survey in Neno district, Malawi, to test validity and reliability. Exploratory factor analysis was performed on a random half of the sample to evaluate internal consistency, reliability and construct validity of items and scales. The identified constructs were then tested with confirmatory factor analysis. Likert scale assumption testing and descriptive statistics were done on the final factor structure. The PCAT-Mw was further tested for intra-rater and inter-rater reliability. RESULTS:From the responses of 631 patients, a 29-item PCAT-Mw was constructed comprising seven multi-item scales, representing five primary care dimensions (first contact, continuity, comprehensiveness, coordination and community orientation). All the seven scales achieved good internal consistency, item-total correlations and construct validity. Cronbach's alpha coefficient ranged from 0.66 to 0.91. A satisfactory goodness of fit model was achieved (GFI = 0.90, CFI = 0.91, RMSEA = 0.05, PCLOSE = 0.65). The full range of possible scores was observed for all scales. Scaling assumptions tests were achieved for all except the two comprehensiveness scales. Intra-class correlation coefficient (ICC) was 0.90 (n = 44, 95% CI 0.81-0.94, p < 0.001) for intra-rater reliability and 0.84 (n = 42, 95% CI 0.71-0.96, p < 0.001) for inter-rater reliability. CONCLUSIONS:Comprehensive metric analyses supported the reliability and validity of PCAT-Mw in assessing the core concepts of primary care from adult patients' experience. This tool could be used for health service research in primary care in Malawi.
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Project description:BackgroundSchool health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS).MethodThe exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi's method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools.ResultsThe coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff's health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach's alpha for all subscales > .93). The test-retest reliability was satisfactory-the intraclass correlation coefficient pooled was .95 (99% CI [.91-.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs' positions at schools.ConclusionThe SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff's health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version.
| S-EPMC8675247 | biostudies-literature
Project description:BackgroundClinical pharmacy plays an integral role in optimizing inpatient care. Nevertheless, prioritising patient care remains a critical challenge for pharmacists in a hectic medical ward. In Malaysia, clinical pharmacy practice has a paucity of standardized tools to prioritise patient care.AimOur aim is to develop and validate a pharmaceutical assessment screening tool (PAST) to guide medical ward pharmacists in our local hospitals to effectively prioritise patient care.MethodThis study involved 2 major phases; (1) development of PAST through literature review and group discussion, (2) validation of PAST using a three-round Delphi survey. Twenty-four experts were invited by email to participate in the Delphi survey. In each round, experts were required to rate the relevance and completeness of PAST criteria and were given chance for open feedback. The 75% consensus benchmark was set and criteria with achieved consensus were retained in PAST. Experts' suggestions were considered and added into PAST for rating. After each round, experts were provided with anonymised feedback and results from the previous round.ResultsThree Delphi rounds resulted in the final tool (rearranged as mnemonic 'STORIMAP'). STORIMAP consists of 8 main criteria with 29 subcomponents. Marks are allocated for each criteria in STORIMAP which can be combined to a total of 15 marks. Patient acuity level is determined based on the final score and clerking priority is assigned accordingly.ConclusionSTORIMAP potentially serves as a useful tool to guide medical ward pharmacists to prioritise patients effectively, hence establishing acuity-based pharmaceutical care.
| S-EPMC9983860 | biostudies-literature
Project description:In The Netherlands, police officers not only come into contact with juvenile offenders, but also with a large number of juveniles who were involved in a criminal offense, but not in the role of a suspect (i.e., juvenile non-offenders). Until now, no valid and reliable instrument was available that can be used by Dutch police officers for estimating the risk for future care needs of juvenile non-offenders. In the present study, the Youth Actuarial Care Needs Assessment Tool for Non-Offenders (Y-ACNAT-NO) was developed for predicting the risk for future care needs that consisted of (1) a future supervision order as imposed by a juvenile court judge and (2) future worrisome incidents involving child abuse, domestic violence/strife, and/or sexual offensive behavior at the juvenile's living address (i.e., problems in the child-rearing environment).Police records of 3,200 juveniles were retrieved from the Dutch police registration system after which the sample was randomly split in a construction (n = 1,549) and validation sample (n = 1,651). The Y-ACNAT-NO was developed by performing an Exhaustive CHAID analysis using the construction sample. The predictive validity of the instrument was examined in the validation sample by calculating several performance indicators that assess discrimination and calibration.The CHAID output yielded an instrument that consisted of six variables and eleven different risk groups. The risk for future care needs ranged from 0.06 in the lowest risk group to 0.83 in the highest risk group. The AUC value in the validation sample was .764 (95% CI [.743, .784]) and Sander's calibration score indicated an average assessment error of 3.74% in risk estimates per risk category.The Y-ACNAT-NO is the first instrument that can be used by Dutch police officers for estimating the risk for future care needs of juvenile non-offenders. The predictive validity of the Y-ACNAT-NO in terms of discrimination and calibration was sufficient to justify its use as an initial screening instrument when a decision is needed about referring a juvenile for further assessment of care needs.
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Project description:BackgroundMeasuring quality of primary care has attracted much attention around the world. Our team has developed and validated an Assessment Survey of Primary Care (ASPC) for evaluating quality of primary care in China. To facilitate the daily use of ASPC, this study aimed to develop and validate a rapid assessment version of ASPC (RA-ASPC) in China.MethodsThis is a multi-phase study on 21 experts and 1,184 patients from 12 primary care facilities in 10 cities in China. Importance, representativeness, easy understanding, and general applicability of each item in ASPC scale were rated to select the top two ranked items for constituting RA-ASPC. Reliability of RA-ASPC was tested by calculating both Cronbach's alpha and McDonald's omega coefficients. Structural validity was assessed by exploratory and confirmatory factor analysis (EFA and CFA). Concurrent validity was performed by analyzing the relationship between RA-ASPC and patient satisfaction. Discriminant validity was tested by assessing the difference of RA-ASPC scores between patients with or without family doctors.ResultsTen items were selected for RA-ASPC. Both Cronbach's alpha (0.732) and McDonald's omega (0.729) suggested satisfactory internal consistency. In EFA, explained variance of RA-ASPC (72.6%) indicated its ability to measure quality of primary care in China. CFA indicators showed convincing goodness-of-fit (GFI = 0.996, AGFI = 0.992, CFI = 1.000, NFI = 0.980, RMR = 0.022, and the RMSEA = 0.000) for RA-ASPC. Positive association between RA-ASPC and patient satisfaction supported the concurrent validity of RA-ASPC. Patients with family doctors perceived higher quality of primary care than those without family doctors, indicating good discriminant validity of RA-ASPC.ConclusionThe theoretical framework of RA-ASPC was in line with internationally recognized core functions of primary care. Good psychometric properties of RA-ASPC proved its appropriateness in assessing quality of primary care from patients' perspectives in China.
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Project description:BackgroundAccurate assessment of COVID-19 severity in the community is essential for patient care and requires COVID-19-specific risk prediction scores adequately validated in a community setting. Following a qualitative phase to identify signs, symptoms, and risk factors, we aimed to develop and validate two COVID-19-specific risk prediction scores. Remote COVID-19 Assessment in Primary Care-General Practice score (RECAP-GP; without peripheral oxygen saturation [SpO2]) and RECAP-oxygen saturation score (RECAP-O2; with SpO2).MethodsRECAP was a prospective cohort study that used multivariable logistic regression. Data on signs and symptoms (predictors) of disease were collected from community-based patients with suspected COVID-19 via primary care electronic health records and linked with secondary data on hospital admission (outcome) within 28 days of symptom onset. Data sources for RECAP-GP were Oxford-Royal College of General Practitioners Research and Surveillance Centre (RCGP-RSC) primary care practices (development set), northwest London primary care practices (validation set), and the NHS COVID-19 Clinical Assessment Service (CCAS; validation set). The data source for RECAP-O2 was the Doctaly Assist platform (development set and validation set in subsequent sample). The two probabilistic risk prediction models were built by backwards elimination using the development sets and validated by application to the validation datasets. Estimated sample size per model, including the development and validation sets was 2880 people.FindingsData were available from 8311 individuals. Observations, such as SpO2, were mostly missing in the northwest London, RCGP-RSC, and CCAS data; however, SpO2 was available for 1364 (70·0%) of 1948 patients who used Doctaly. In the final predictive models, RECAP-GP (n=1863) included sex (male and female), age (years), degree of breathlessness (three point scale), temperature symptoms (two point scale), and presence of hypertension (yes or no); the area under the curve was 0·80 (95% CI 0·76-0·85) and on validation the negative predictive value of a low risk designation was 99% (95% CI 98·1-99·2; 1435 of 1453). RECAP-O2 included age (years), degree of breathlessness (two point scale), fatigue (two point scale), and SpO2 at rest (as a percentage); the area under the curve was 0·84 (0·78-0·90) and on validation the negative predictive value of low risk designation was 99% (95% CI 98·9-99·7; 1176 of 1183).InterpretationBoth RECAP models are valid tools to assess COVID-19 patients in the community. RECAP-GP can be used initially, without need for observations, to identify patients who require monitoring. If the patient is monitored and SpO2 is available, RECAP-O2 is useful to assess the need for treatment escalation.FundingCommunity Jameel and the Imperial College President's Excellence Fund, the Economic and Social Research Council, UK Research and Innovation, and Health Data Research UK.
| S-EPMC9333950 | biostudies-literature
Project description:ObjectivesTo develop a simple dementia screening tool to assist primary care physicians in identifying patients with cognitive impairment among subjects with memory complaints or at a high risk for dementia.DesignThe Brain Health Test (BHT) was developed by several experienced neurologists, psychiatrists, and clinical psychologists in the Taiwan Dementia Society. Validation of the BHT was conducted in the memory clinics of various levels of hospitals in Taiwan.ParticipantsAll dementia patients at the memory clinics who met the inclusion criteria of age greater or equal to 50 years were enrolled. Besides the BHT, the Mini-Mental State Examination and Clinical Dementia Rating were used to evaluate the cognition state of the patients and the severity of dementia.ResultsThe BHT includes two parts: a risk evaluation and a cognitive test (BHT-cog). Self or informants reports of memory decline or needing help from others to manage money or medications were significantly associated with cognitive impairment. Among the risk factors evaluated in the BHT, a total risk score greater or equal to 8 was defined as a high risk for dementia. The total score for the finalized BHT-cog was 16. When the cutoff value for the BHT-cog was set to 10 for differentiating dementia and a normal mental state, the sensitivity was 91.5%, the specificity was 87.3%, the positive predictive value was 94.8%, and the negative predictive value was 80.1% The area under the receiver operating characteristic curve between dementia and healthy subjects was 0.958 (95% CI = 0.941-0.975).ConclusionsThe BHT is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.
| S-EPMC5918945 | biostudies-literature
Project description:OBJECTIVE:To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. DATA SOURCES/STUDY SETTING:Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423). STUDY DESIGN:Confirmatory factor analysis. DATA COLLECTION:Thirty-eight questions organized in six domains: Access and Continuity of Care, Planned Care for Chronic Conditions and Preventive Care, Risk-Stratified Care Management, Patient and Caregiver Engagement, Coordination of Care across the Medical Neighborhood, and Continuous Data-Driven Improvement. PRINCIPAL FINDINGS:Confirmatory factor analysis suggested using seven factors (splitting one domain into two), reassigning two questions to different domain factors, and removing one question, resulting in high reliability, construct validity, and stability in all but one factor. The seven factors together formed a single higher-order factor summary measure. Factor scores guard against potential biases from equal weighting. CONCLUSIONS:The M-PCMH-A can validly and reliably track primary care delivery across practices and over time using factors representing seven key components of care as well as an overall score. Researchers should calculate factor loadings for their specific data if possible, but average scores may be suitable if they cannot use factor analysis due to resource or sample constraints.
| S-EPMC5867087 | biostudies-other
Project description:ObjectivesThe present study aimed to translate and determine the psychometric properties of the Persian version of the Compassionate Care Assessment Tool (CCAT) ©.MethodsThe study was carried out to translate and validate of the CCAT©. After securing permission from the designer of the tool and translating it, the psychometric properties were determined through examining face validity, construct validity, internal consistency, and test/retest reliability. With regard to construct validity, confirmatory factor analysis was used so that 300 patients in internal and surgery wards were selected by a simple random sampling method from three hospitals. Data were analyzed using SPSS (v.24.0) and LISREL statistical software version 8.8.ResultsThe results of the confirmatory factor analysis supported the validity and reliability of the Persian version of the CCAT© and its four factors. The reliability of the tool and internal consistency were confirmed through test/retest method with two weeks' interval. At the two areas of importance and provision of compassionate care, Cronbach's α coefficient equaled to 0.918 and 0.933 and intraclass consistency equaled to 0.848 and 0.907 respectively.ConclusionThe results showed that the Persian version of the CCAT© was adequately valid and reliable for Iranian patients. Given the acceptable psychometric parameters of the tool, using it in future studies to measure importance and provision of compassionate nursing care to Iranian patients at internal and surgery wards is recommended.
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